Can Bariatric Surgery reverse/cure Diabetes?
This is one of the common questions which is being asked on various platforms. So I decided to answer it here.
For a long time, diabetes was considered a chronic disease whose fate used to end in one of its many complications. For detail on Diabetes and its short/long term complications, read here What is Diabetes? What is the status of Diabetes in India & the World?
But the arrival of bariatric surgery has forced everyone to reconsider various possibilities.
Can bariatric surgery really reverse or cure diabetes?
Before I answer that let me clarify one thing first. Here we are talking about Type 2 diabetes (not type 1 diabetes). Because in type 1 diabetes, your immune system destroys the cells of the pancreas which make insulin. So there is no insulin to begin with. Even if you are going to get bariatric surgery done, nothing good is going to happen.
On the other hand, in type 2 diabetes the problem is not only insulin production entirely but insulin resistance also. It simply means your body is making insulin but insulin fails to do its work because of fat deposited on various tissues. If I make it further simple, insulin is there, insulin wants to take action on the target cell but that target cell is covered with fat and insulin can’t act. Are we good here? Let’s move on.
So let’s modify the question.
Can Bariatric Surgery reverse/cure Type 2 Diabetes?
Before that, you should know how bariatric surgery works and how it can possibly cure/reverse type 2 diabetes.
See the problem with type 2 diabetes is that our body has stored more fat than it should have. Now that excess of fat is blocking the action of insulin. So how we will cure type 2 diabetes? By removing that excess of fat so insulin can take its action. Sounds good.
We can remove that excess of fat with diet and exercise also. But that takes a good amount of commitment, perseverance and patience. But we are not patient anymore. We want everything as soon as possible.
Laziness is not the only reason to get bariatric surgery done. Sometimes due to obesity people get serious health issues. They do need to lose fat quickly else their life hangs in balance. For those people, bariatric surgery comes as a life saviour.
How bariatric surgery works?
In this surgery, the surgeon will cut a part of your stomach and reduces its size. Sometimes the surgeon will not cut the stomach but will put a band around the stomach to reduce its size. The advantage of banding is that it can be removed later.
Now we have reduced the size of the stomach. A smaller stomach means when you will eat food, it will get full earlier. If you will feel full earlier, you will eat less. Less intake of calories means weight loss. Weight loss is mainly caused by fat loss. So there you go. The fat that was blocking your insulin is gone now. Insulin is working again and your diabetes (type 2) is gone.
Does it really work?
According to many studies, Diabetes was completely cured in 78.1% of people undergoing bariatric surgery. 86.6% of people were able to achieve better blood sugar control. And there was an average weight loss of 38.5kg. Not only that there was an 80% reduction in the use of oral anti-diabetic drugs and a 79% reduction in artificial insulin use.
In another study, it was seen that the recovery rate from diabetes was 3 times more after bariatric surgery. And the best result was seen in one type of study where 97% of the people with bariatric surgery was able to bring back their blood sugar to normal. Amazing, isn’t it. This was the effect of bariatric surgery on people with a BMI >35 KG/M2.
Read here for more info on BMI —-> What’s the difference between being Overweight and Obese?
Which category of diabetics gets the most benefit?
People who were diabetic for short duration i.e less than 5 years received the most benefit.
Is there a chance your diabetes will come back?
According to follow up studies, people remained diabetic free even for 16 years long follow up.
All this data shows that bariatric surgery is in fact able to reverse/cure diabetes and not only that it can reduce death from diabetes by 92%.
What about bariatric surgery in people with BMI <35 KG/M2?
Ok doc, but that data was about people with BMI >35 KG/M2. What data says about those whose BMI <35KG/M2?
Let me share that data also. According to studies, there was an average reduction in BMI value by 5.1 kg/m2 and 85.3% of people were able to control their blood sugar level without antidiabetic medicine.
- People with higher BMI (30–35 kg/m2) achieved better results than people with comparatively lower BMI (25–29.9 kg/m2)
- 1.7 % of patients needed Re-operation.